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HomeMy WebLinkAbout07-01-08 REGISTER OF WILLS OF C ~ /J? 13E12L~ ~~ COUNTY, PENNSYLVANIA K pp /,r Estate of Do ro//[ ~/ ~J' ~ Qq~~S also known as Deceased File Number ~~ r °~~~ b Social Security Number ~7~ ' ~~ y 7`3T Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' a• 'B' I3ELOG{4) ® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s)ts /are the Co' UC~~7 named in the last Will of the Decedent dated /¢t ~( ~ ~ 993 and codicil(s) dated (Stole relevant circumstances, e.g., renunciation, dentL of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution ~he insttvmet~) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person:- ~ ~ ~ _ C7 r ~~ i t- `. ^ B. Grant of Letters of Administration ~~ t F r '---'' (/f applicable, enter.• c.t.a.; d.b.n.c.t.a.; perrdente life; durance absentia; dur ~dt~-hate) - 4' Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following ~:y~=(i~ any) ark heirs--{lf;''_:: Adtrtinisp•ation, c.t.a. or d.b.n.c.t.a., enter date of Will in Sectiat A above and complete list of heirs.) ~ ~-'~, Name Relationship Residence VJ (COMPLETElNALL CASES:) Attach additional sheets ift:ecessaty. Decedent was domiciled at death in lt.Il~ ~ICI'~ County, Pennsylvania with :his /her last principal residence at ~~D(D (List street address, town/cit)~, township, counn~, state, >ip code) ZooB ~A / Decedent, then -C~ years of age, died on dune ~~ at /'/C SS ~~ ~ y~ /laye Decedent at death owned property with estimated values as follows: on (If domiciled in PA) Al] personal property $ /oi o00 (lf not domiciled in PA) Persona] property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ Yo, DOO. oO Form RtP-0? rer. l0.1i.06 Pave 1 Of 2 situated as follows: /OpG E. Caorel' ~, /11eehQn-GS~tert ~hottg~,~Cwn~„dG!-~q~ '~N,ri.~ ~f~ Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: rv ~ ~ t_.. _ ~-oc7 rte-- Oath of Personal Representative ~~ ~ , ,y- s `yl COMMONWEALTH OF PENNSYLVANIA SS ~3~© ~ ~~ `'-~-' COUNTY OF C U MAEJ~L/~/U,D ~~-~ - ,-: The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true ai~id correct to ~ best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. 1 ~ Sworn to or affirn~ed and subscribed before me the ___L__~ day``of j ! ,For he Register File Number: 02. ~~ O~ -~ `~OQ Estate of ~oI?Or'yy g• ~~/~ 6~Nf ,Deceased Social Secur' Number: t 7'~ ~ ~~_ yY3 y Date of Death: fknC ?Z , ZdG$ AhID NOW, ~ ,~ ~ co/nsidera ion of the foregoing Petition, satisfactory proof having been presented b ore , IT IS DEC ED that Letters- 1Zl~K" l~-~ are hereby granted to ~. ~ C C ~ ~ ~ 1~~1d ~~~ in the above estate and that the instrument(s) dated described in the Petition be admitted to FEES ~ 1 Letters ............... $ (_ f,J~/J (.~ Short Certificate(s) ........ $ Renunciation(s) ...... $ w~'•I ~ $- t~~~-- f -~.. $~_ ... $ ... $ ... $ ... $ ... $ .. $ TOTAL .............. $ . C Sr~natw•e ojPersonal Representative wict~/.¢M .¢. N/ GiA/ x , Signaaa•e ojPersor 1 Representative N.¢.VC Y l . W ooDkJ~R~ Signature ojPersatal Representative and filed of record Attorney Signature: Address: lD C'/4~.s~~ ~1 Q~ fYle~han:c's6tir9. ~~ /7osS Telephone: ~i ~- ~~c -ozo Forty R6V-U? rer !0.1.3.OG pflge ~ Of 2 Attorney Name: C'lQr~Cs ~ d 17~ e%7'S Supreme Court I.D. No.: _ 3 ~5~3 _ 105.2iQS REV t(111U'I LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. I Fee for this certificate. $6.Q0 P ~45~8966 Certification Number ~~',n ~3 sli~~l~ r~eu~'_~ i7~-c~-~~3~{ This is to certify that the information here given is correctly copied from an original Certificate of Death duly tiled with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. >~ocal Registrar Date Issued 0 °c~ ~ {- ~~x ~~~ ~D ~ f ~ . ~ ~ :._ I ,_;? ,_, _ Z t.. j '^ i C.A~ - f N1o5-u3 REV nnoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS 7Y~E/RAN CERTIFICATE OF DEATH BLACK IPNC (See instructbns end examples on reverse) STATE FILE NUMBER N N .~ O W 7 1 ~I 0 0 ~d 1. Name d Decederd (FUm, rtitlde, lain, sulfa) 2. Sea 3. Swim Security Number 4. Dam d Deam (Month, aay, year) Doroth B. Hi ins F mat 192 -01 - 4434 June 22, 2008 6, Age (lam emnday) Umer 1 year llrlder 1 day 6. De1e d Binh (Mmm, day, year) 7. BiM1hplace (Cky arse smm «f ~ wtaary) Ba. Place of Deem (Check on one) slw+na Data No,av IIMes - Hospital: abet. 9 0 yre_ July 16 , 1 91 7 Harrisburg , P a . ^ Irlpedenl ^ ER / Oulpalianl ^ DOA [~ Nurmng Home ^ Residence ^aMr - Spedty: !b. County d Deem Bc. City, T Demh Btl. Facity Name (K nd nsGuYon, gNe mrem end dmY>ar) 9. Was DacedeM al Hispannaign? $] too ^ Yes td. Race: American khan, Black, WAile, etc. Cumberland Upper Allen ES'S/Ahf~ (fj/,Z~ ~ U1 Vim. sPedh Cuban, Meaican,Pa.npf?kan,eR.) (SpaaM White 11. Decadwd's 1lsuad Kad d wok d one du ~ rtgsl d ~ tih. Do nd stela re' 12. Wes Decetlenl ever In me 13. Dec«mnYS Educe IAN onN ^ig~ 9~ c«nP mled) 14. Medial 9atus: Merned, Never Marred, 16. SuMvng Spo use (d wile, give maiden name) KvN d 1Vak Kkd d Bl6kleas / kWUSSy U.S. Amled Forces? Elementary / SecoMary (ail) College (1~4 or 5.) Witlowed, Divomed (SpedM Clerk Comm, Of Pa. ^Yea C~7o 12 rs, Widow 16. Decedent's Maikg Address (S1reeL cKl' /lam, state, zip wtle) 1006 East Coover St llecedml's Did Deced«a Acura Resimrca ,7a. sam Pa• are+^a nd.^Yae. oecedmt Livedn crop. , Mechanicsbur Pa 17055 170,~,n,Y Cumberland T°"r~'"? ,7d.[~Na,Da~eam,livedwMm Mechanicsburg g, , AdaaIlLaR al /e«a i6. Fam«'s Name (Fem. nYdde, nm, sul6a) 19. Homer's Name (Flrel, mkkle, maiden wmemej Ira C. Blocher Emma C Stonesifer 20e. ml«rtWU's Hams (Type /PHI) 26b. mlptmm,rS Haying Atltrass {Sheet, coy / aam, Slam, zip coda) Nancy L, Woodward ~ 20 Shirle Lane Boiling Springs,Pa. 17007 21 e. IAaatod d DLsposibon g] Cremmlon ^ Donetlon ' 21b. Dam d Dapomfion (Modh, day, year) 21c. Piece d DsDosdlon (Name d cerrwlery, «emat«y «omer piece) 2fd. Larabon (City /form, slam. aP corle) ^ Badm ^ RemovmlranSmte ~w.acrematlm«O«wtbnAattrmud June 23 2008 Hollinger FH/Crematory Inc. Mt,Holly Spgs.Pa.1706 ^ Diner - speary: M rwlw ELminay f c«otrn ®Yas ^ No r 22a. SkyWUra d Funarm Berries ' (« person etling as such) 226. I.kmse Number - 22c. Nand aMAdNesa d Fadliy 5 0 N . B a 1 mOr e V e , FD-0115-89-L Hollinger FH/•Crematory Inc. Mt,Holly Springs, Pa. 17065 Conpkm gams 23at ady when cenilyng . To tlw bem d my IanwNdga, deadl ooaned m me time dak and place slated. {Sigtmura and thin) 23b. License Nwrlber 23c. Dam Signatl (MOnm, day, year) physiien a m aveiable m 6nle a deem m cavity cause d dean kerns 2F2fi nxat b ~ bl, P~~ 24. Time of Deem 25. Dais P Dead (Monet, di y Year) 28. Was Case Relened to Medkal Ewminer / Coroner f« a Reason Omer man Cremalian a Donatbn7 w41o pronaawes deem. f 0 I I ,^ M, p ~ ~ 6 Z Z. ~ 0 ^ Yes ^ No CAUSE OF DEATH (Sae instnctlons acrd szsmpbs) r Approximate imm~m: Pan II: Eder odwr gigfyf~ t aor„BSnc mnMtvgM m loam, 28. Did Td'acm Use C«itrihlae to Deam7 Item 27. Parr I: Edm me - ®seases, kpnias, «c«rpGCagms -mm direcay caused tlw deem. DO NDT eder terminal evenB each es cardiac arrest a Onset m Deem but rml resullsq n the IaldBnylnq cause given n Pan 1. ^ Yes ^ PrWady respkauxy arrem, «verariWer fibrillalnn wahoa showin g t d io l og y li m a h ~ 1y one cause an eaM Ikte. ~ d/ ~ ~ ~ / ~~ ~. ~~ Y, l' ml~ ~WIMg n ~f N « p~.~ ,~yy ~~ , GY G - ~ - ~ ~ ~ ~ 29. M Fronde: ~ . Due b (« sc a'casegratra ol). i ^ p regnanl m Inns of deem ~ ~a1y ~ ~~• 6 ~~ b. s Ib ' baArlo the cause I sled on Ins a. r Saar me UNDEiLLYNO CAUSE Dus m (« es a catserywnce ol): r ^ Nq pregred, bd preplant wiNn 42 days ~arase or "' ay mat m~aled tle o, r dwlk remAllr i In demh Lj ABL d ~ y D~ m (« as a conssqusree o1): i ' ^ Na fue¢anl, bd pregnad 43 days m 1 year r d. r bebre damn Unkmwn 6 pegnanl wilhn ds pall year 30s. Was an Aumpsy 30b. Were Aumpsy Fndaxp 31. Mahler a Deam 32a. Dine of mPIrY (MOdh, day Year) 32b. Deacnbe Now Inlury axumd 32c. Place d Injwy: floes, Farm, Brest, Facmry, Pen«awd7 Available Prbr la Completion d cause d Deem? ~-/ tuM ^ Flonxcde }tries t3ffice Baldrig, ek. (Specrry) ,,__,,(( ^ Va '~(I No ^ Yes ^ No ^ Arotlwn ^ PeMng Investigedon 32d. Time of lryisy 32e. injury al W«k? 32f. II Trensparmtion Input (SpealyJ 32g. L«alion d mWly 4Snem, cdY! town, state) /~ ^ Sukide ^ CauM Nd hs DemmMed ^ Yes ^ No ^ a^'er / Operel« ^ Fasserger ^Pedemnan M ahem Specify 33a. Certifier (deck «eY one) ......... • Cer+KNh9 PhYmcfm (Physician cen4yirg cause of deem when anomer ~ysidan has pronourcetl deem and complded Item 23) 33b. SgnaWre and \ralier ~~ TolM hemamy knosMd94 damh occwreddwmthecwaels)an0 rnenroras staled,________________________________ • Pr«Iwlckg and terlaykp ptryeicin (Physcian bdn pr«wunarg deem and certiM^9 b cause of tleam) 33c. License mbar 33d. Dam Signal (Modh, day, year) _ _ _ To the bnl a my krowkdge, deem acumad m tns lima, rLSe alW plaq, and due to the uuae{s) and meamx as slated. _ _' _" _ _' _ /i1'\ r~,~cc~ _ `/ ~ / _/ '1 ?~~.`~ • Medlcsl ExaMrerlComrw On tM bWk d exalNrretlan and 7 or NrveallgaBon, in my oplnbn, dWh xclrred m dte tYna, dale, and Place, end dw to lM wuae(e) sM es %m~- ^ ~ ~ /V~.-/~~(~~r( CB PJ ~-LiJ ~, Name endue reu P«son Ylfa Completed su5e of Dsam Item 27) Type / PMI ` 35. 's ~ lure Di Number I f .I 1 1 1~ I t a 3fi. le Feed (MOdh, day, yea !, ,~`z -~" /O"D /~~f ~~Q = i Zel4 S~ ~ c l r ra~Asa~~ ~~~ ~ ~d~~ ~ ~ Dapositbn Permit No. S tr r , % LAST WILL AND TESTAMENT OF DOROTHY B. HI IN l.j~~~V- I, DOROTHY B. HIGGINS, unremarried widow, of the Borough of Mechanicsburg, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do make, publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath in equal shares unto m;y two (2) children, William A. Higgins and Nancy L. Woodward. Should my said son, William, predecease me or die at about the same time as I do such as in a common disaster or accident, and should he be survived by issue, then to them, per i s. Should he not be survived by issue, then to my said daughter, Nancy. Should my said daughter, Nancy, predecease me or die at about the same time as I do such as in a common disaster or accident, then to my said son, V~Jilliam, pgr sue. 3. I nominate, constitute and appoint my son, William, and my daughter, Nancy, to be the Co- Executors of this my Last Will and Testament. I further direct that the}~ shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF, I have hereunto set my hand and sera this `7%~v day of A.D. 1993. '~~~ ~ $~/ (SEAL) ~ ~/,./ Signed, sealed, published and declared by the above-named DOROTHY B. HIGGINS as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. a+ c~ _ ~ ~~ t J ~~ ( `? o~ C~ _i o a N ~':'~~~ - ,-~ r -_1 .. t~a~ .. ~~ t -'v ~ W~t ,r. ~. _.._ 2~'G8 JUl. - I AM t I ~ 39 OATH OF SUBSCRIBING WITNESS(E~~G ~~ REGISTER OF WILLS ~R~~?t°~ Q.•, PA C~IMpE~?L~4•~t~ COUNTY, PENNSYLVANIA Estate of ~D~P_OTyS/ ~. ~/<GG~NS ,Deceased G'y/1~/l~ES ~• Sy«~`s~ ~~a subscribing witness to (Print Nmne/s) the ~ Will ^ Codicil(s) presented herewith,.~sl~}being duly qualified according to law, depose(s) and say(s) that ~/ he /-~~e3c was /-~er~ present and saw the above T-•-~ `~~/ Testatrix sign the same and that ~kef he /-t~s3~- signed the same and that ~ke~ he /-~e3~- signed as a witness at the request of the ~es~tor# Testatrix in herd presence and in the presence of each other. Gr (Signatw•e)CN/~•/QL4 ~C. J~'/Sl/EZ DS ~[ (Signature) l¢ Clouser !~a/. (Sd•eer Address) /~,~a~t~cs~u,r~, ,off /?oSS (City, State, Zip) (Street Address) (City, Stale, Zip) Executed i~z Registe~•'s Office Swon~ to or affirmed and subscribed before me this l~~ /day Executed oact ofl~egiste;+•'s Office Sworn to or affirmed and subscribed before me this day of , of Wills Notary Public NIy Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) NOTE: To be tal.en by Officer authorized to administer oaths. Please have present the original or copy of instrument{s} at time of notarization. Form RlY-03 rev. /0./3.06 1f/~g JAL `! "~~//: ~~ OATI-~[ OF NON-SUBSCRIBING WITNES~S~~~~~K pF' ~~'~P~~~~~R~. REGISTER OF WILLS ~ C It ~11,(~6~1.¢A1~ COUNTY, PENNSYLVANIA Estate of ~be2o ~.y y ~ ~I~CG/NS w/~U~lyl ~r . ~1/(~G//1/,t and -Fe,acl~) being duly qualified according to law, depose(s) and says} that acquainted with ~~P.OT~S/Y g. /S//G 6/NS Deceased _.~, he,~e~ waste- Well- and and familiar with the handwriting and signature of the decedent, and that the signature of .~ Q2bTi5/y ~. /yl~~,i(/S to the foregoing instrument purporting to be the Last Will and TestamentlCodicil of ~bRrvT.t/}/ /~. '!G~/~YS is in der own proper handwriting. ~~ ~ ~. Signature) ~~~~ ~/~ A • u! ~f ~ .S~~Do/t~sii~/Te /fi=r. (Street Address) ~'1?ec~f 4n ~c~ur9,,0,~ /7oSS (City, State, Zip) Executed in Register's Office Sworn to or affirmed and subs.-ribed before, this ~ - day of ~~ d~i Form RlY-04 rev. !0.!3.06 (Signature) (Street Address) (City, State, Zip) 1" rT' ~ ~ ~